Cognitive impairment and an episode of major depression as independent factors of delirium after cardiac surgery. Prospective observational study
Journal Title: Postępy Nauk Medycznych - Year 2011, Vol 24, Issue 8
Abstract
Introduction. Delirium is a frequent and serious complication of cardiac surgery. However, the knowledge regarding risk factors of delirium is still limited. The aim of the current study is to assess whether cognitive impairment and depression are independent predictors of postoperative delirium.Material and Methods. The study recruited 563 subjects scheduled for cardiac surgery. The patients were preoperatively examined with the use of the Mini-Mental State Examination and the Mini International Neuropsychiatric Interview to assess cognitive functions and psychiatric comorbidity. Moreover, other variables connected to the patients’ medical condition and perioperative procedures were entered into analysis. A diagnosis of postoperative delirium was made according to DSM-IV criteria.Results. The frequency of postoperative delirium was 16.3% (95%CI 13.5-19.6). Preoperative cognitive impairment and major depression were diagnosed in 100 (18%) and 35 (6%) patients scheduled for surgery, respectively. Multivariate stepwise logistic regression analysis revealed that preoperative cognitive impairment and an ongoing episode of major depression are independent predictors of delirium after cardiac surgery.Conclusions. It is advisable to screen patients referred for cardiac surgery for the presence of cognitive impairment and major depression since these conditions increase the risk of postoperative delirium. The findings of the present study might be helpful in reducing the risk of delirium and improving the medical care of patients undergoing cardiac surgery.
Authors and Affiliations
Jakub Kaźmierski, Maciej Kowman, Wojciech Fendler, Karol Woźniak, Andrzej Banyś, Ryszard Jaszewski, Tomasz Sobów, Iwona Kłoszewska
Keywords
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